Authentic leadership, job satisfaction and organizational commitment: The moderating effect of nurse tenure

The effect of career compromise on nurses' turnover intention: the mediating role of job satisfaction

AIM

We aimed to examine the relationships among nurses' career compromise, job satisfaction, and turnover intention and the mediating role of job satisfaction in the relationship between career compromise and turnover intention.

BACKGROUND

Nurses are prone to career compromise when there is a discrepancy between the reality of their job and their personal career expectations due to personal or family factors. High levels of career compromise may have a significant impact on turnover intentions through low job satisfaction, thereby affecting the stability of the nursing workforce. There is a paucity of research on the impact of nurses' career compromise on turnover intentions.

METHOD

This was a cross-sectional research design of nurses in hospitals in Guangdong Province using a convenience sampling method. The Career Compromise Scale (CCS), Job Satisfaction Scale (JSS), and Turnover Intention Scale (TIS) were used. The obtained data were analyzed through descriptive statistics, Spearman's correlation coefficient, and the mediating effect of perceived organizational support was tested through the PROCESS macro mediation model in SPSS.

RESULTS

Data from 821 nurses who met the inclusion criteria were analyzed. The total score of nurses' turnover intention was 14.68 ± 4.32. Spearman's correlation analysis showed that career compromise was negatively correlated with job satisfaction (r = -0.594, p < 0.01), job satisfaction was negatively correlated with turnover intention (r = -0.471, p < 0.01), and career compromise was positively correlated with turnover intention (r = 0.544, p < 0.01). The mediating effect of job satisfaction on the relationship between career compromise and turnover intention has been demonstrated. The mediating effect is significant, with a value of 0.056, representing 25.71% of the total effect.

CONCLUSIONS

The turnover intention of nurses in Guangdong Province is high. Job satisfaction mediated the relationship between career compromise and turnover intention. This study further enriches JD-R theory and COR theory and provides new perspectives for nurse managers to develop intervention strategies to stabilize the nursing workforce and reduce turnover.

Leadership support and satisfaction of healthcare professionals in China's leading hospitals: a cross-sectional study

BACKGROUND

Healthcare professionals' job satisfaction is a critical indicator of healthcare performance, pivotal in addressing challenges such as hospital quality outcomes, patient satisfaction, and staff retention rates. Existing evidence underscores the significant influence of healthcare leadership on job satisfaction. Our study aims to assess the impact of leadership support on the satisfaction of healthcare professionals, including physicians, nurses, and administrative staff, in China's leading hospitals.

METHODS

A cross-sectional survey study was conducted on healthcare professionals in three leading hospitals in China from July to December 2021. These hospitals represent three regions in China with varying levels of social and economic development, one in the eastern region, one in the central region, and the third in the western region. Within each hospital, we employed a convenience sampling method to conduct a questionnaire survey involving 487 healthcare professionals. We assessed perceived leadership support across five dimensions: resource support, environmental support, decision support, research support, and innovation encouragement. Simultaneously, we measured satisfaction using the MSQ among healthcare professionals.

RESULTS

The overall satisfaction rate among surveyed healthcare professionals was 74.33%. Our study revealed significant support from senior leadership in hospitals for encouraging research (96.92%), inspiring innovation (96.30%), and fostering a positive work environment (93.63%). However, lower levels of support were perceived in decision-making (81.72%) and resource allocation (80.08%). Using binary logistic regression with satisfaction as the dependent variable and healthcare professionals' perceived leadership support, hospital origin, job role, department, gender, age, education level, and professional designation as independent variables, the results indicated that support in resource provision (OR: 4.312, 95% CI: 2.412 ∼ 7.710) and environmental facilitation (OR: 4.052, 95% CI: 1.134 ∼ 14.471) significantly enhances healthcare personnel satisfaction.

CONCLUSION

The findings underscore the critical role of leadership support in enhancing job satisfaction among healthcare professionals. For hospital administrators and policymakers, the study highlights the need to focus on three key dimensions: providing adequate resources, creating a supportive environment, and involving healthcare professionals in decision-making processes.

A systematic review of leadership styles in healthcare sector: Insights and future directions

In light of the ongoing global health crisis, the significance of leadership within the healthcare sector has intensified. Given this consideration, the significance of appropriate leadership styles cannot be overstated. The objective of this paper is to critically review published studies on leadership elements in the healthcare sector. Using Bibliometrix R package and VOS viewer, we conducted bibliometric and network analyses on publications retrieved from the Web of Science (WOS) database, with content analysis integrated throughout the paper to deepen understanding. Ultimately, 243 articles were identified as relevant. The findings revealed transformational leadership emerges as the most extensively discussed leadership style. 91% of the articles' theme focus on quantitative research methods. This study synthesizes the influencing factors of the three most frequently discussed leadership styles-transformational, authentic, and ethical leadership-emphasizing the importance of job satisfaction and organizational citizenship behavior. And provides direction for future research through thematic analysis.

[Sistematic review on the influence of leadership style on job satisfaction of health professionals]

INTRODUCTION AND OBJECTIVES

Healthcare organisations are highly complex entities that live with a high risk of instability. In order to minimise this instability, interactions and personal relationships play a major role and accordingly the figure of the leader gains full significance. The leadership style used can produce different reactions and lead to multiple outcomes, including job satisfaction. The aim of the present review is to correlate leadership style with job satisfaction in healthcare professionals.

MATERIAL AND METHODS

A systematic review was carried out in BVS, Cochrane plus, CINAHL, ApaPsycinfo and Pubmed, selecting publications that mentioned leadership styles and job satisfaction in healthcare professionals. Publications search strategy were limited for the 5-10last years, full text availability and language of writing: English, French and Spanish. Review-type publications were excluded. Of the 1566 initial titles, 15 were selected for analysis.

RESULTS AND CONCLUSIONS

The transformational style showed the highest number of positive correlations, followed by the authentic and transactional styles. On the other hand, the passive and laissez-faire styles showed a negative correlation regardless of the professional category to which they belonged. The results of this study provide a starting point for adopting effective leadership styles to optimise the recruitment and training processes of staff in management and coordination roles.

Linking abusive supervision to service sabotage through work alienation in nurses: A cross-sectional study

BACKGROUND

Abusive supervision has detrimental effects on nurses, but the mechanisms connecting abusive supervision to negative outcomes for nurses have not been well-established in the nursing literature.

AIM

This study aimed to investigate whether work alienation mediates the relationship between abusive supervision and nurses' service sabotage.

METHODS

This descriptive cross-sectional study was conducted from November to December 2021 with 204 nurses working at a teaching hospital in Damanhour, Egypt. Data were collected using a demographic information form, the Abusive Supervision Scale, the Work Alienation Scale and the Service Sabotage Scale. Study hypotheses were evaluated using structural equation modelling.

RESULTS

Our findings revealed a significant association between abusive supervision, work alienation, and service sabotage among nurses. Abusive supervision was found to be linked to nurses' service sabotage through work alienation.

CONCLUSION

Our study suggests that nurses who are subject to abusive supervision are more likely to feel alienated, which increases the probability of them engaging in behaviours that have a negative impact on the quality of care they provide.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

The influence of nurse managers' authentic leadership style and work environment characteristics on job burnout among emergency nurses

BACKGROUND

Emergency nurses experience excessive workloads and high job burnout. Limited evidence exists exploring the role of authentic leadership and nurse work environment on job burnout among emergency nurses.

OBJECTIVE

To assess the influence of nurse managers' authentic leadership and nurse work environment on job burnout among emergency nurses.

METHODS

A cross-sectional study was conducted among 160 emergency nurses working in six hospitals in the Sultanate of Oman. The Maslach Burnout Inventory, Authentic Leadership Questionnaire, and the Practice Environment Scale of the Nursing Work Index were used to assess study variables.

RESULTS

Of the 233 distributed surveys, 160 emergency nurses responded resulting in a response rate of 69%. More than two thirds of emergency nurses (72.1%) reported high levels of burnout. Authentic leadership and a favorable work environment were significantly associated with lower job burnout. Nurse managers' transparency (β = - 0.481, p = 0.031), ethical/moral conduct (β = - .408, p = 0.043), managerial ability and support (β = - 0.497, p = 0.018), and adequate staffing and resources (β = -.068, p = 0.028) were all associated with lower job burnout.

CONCLUSIONS

Results suggest the importance of providing effective leadership, adequate support to staff, maintaining optimum staffing and resources, and developing nurse managers' authentic leadership to reduce nurses' job burnout.

Authentic leadership, organizational culture and the effects of hospital quality management practices on quality of care and patient satisfaction

AIM

To examine the influence of hospital culture and authentic leadership on the effects of quality improvement practices on patient satisfaction.

BACKGROUND

Nurses in formal leadership roles shape and are shaped by organizational culture to achieve high performance standards to influence quality of care.

DESIGN

Using structural equation modelling, we tested a model on quality improvement practices across three participant groups that differed based on authentic leadership and hospital culture.

METHODS

We used survey data from a cross-sectional study conducted in 2015 measuring nurse. Managers' perceptions of authentic leadership, implementation of quality improvement, and organizational culture in Canadian hospitals.

RESULTS

226 nurse managers participated. Our model estimations fit for the high-relational group and mixed group. Our model explained 50.7% and 39.5% variance in our outcome variable of patient satisfaction for the high-relational group and mixed group, respectively. Our model failed to fit the low-relational group.

CONCLUSION

Authentic leadership and developmental/group hospital cultures improve quality management practices, quality of care and patient satisfaction. In organizations with low authentic leadership and hierarchical/rational cultures, strategies should target increasing authentic leadership and shifting to developmental cultures. Organizations with high authentic leadership and/or developmental/group cultures should target employee engagement, autonomy and teamwork.

IMPACT

We examined how different combinations of authentic leadership and hospital culture influence the effects of quality management practices on quality improvement and patient satisfaction. Findings demonstrate that having both high authentic leadership and developmental or group hospital cultures are essential for quality improvement practices to enhance the quality of care and patient satisfaction. These organizations would benefit the most from systemic programs aimed at standardizing quality management practices as they have the culture and leadership to support these practices. For hospitals with hierarchical/rational cultures and/or low authentic leadership, enhancing hospital culture and leadership through leadership training and accreditation programs is critically needed.

PATIENT OR PUBLIC CONTRIBUTION

The College and Association of Registered Nurses of Alberta contributed to this study by facilitating data collection and supporting the conduct of the study through messaging to its members.

Does authentic leadership promote higher job satisfaction in public versus private organizations? Exploring the role of vigor and engagement

Background

Several studies have suggested that leaders showing high levels of authentic leadership increase workers' overall job satisfaction, which is composed of different aspects with some distinctions among them. Furthermore, the implication of affective and motivational variables, such as vigor and engagement at work, respectively, have not been jointly considered for analysing the differences and similarities between public and private organizations. Thus, this study aims to analyze whether vigor at work and engagement at work play a mediating role between authentic leadership and different aspects of job satisfaction, considering both public and private organizations, to propose a trans-organizational model.

Method

In this cross-sectional and cross-sectoral study, 1029 workers in private (n = 619) and public (n = 410) organizations from Spain participated completing a questionnaire.

Results

Structural equation modelling was used to perform a multigroup mediation analysis (public versus private organizations) in which the invariance between groups was previously explored. The model showed a good fit to the data in which authentic leadership affected the dimensions of job satisfaction both directly and indirectly (through vigor at work and engagement). However, authentic leadership had a greater positive effect on vigor at work for private organizations; whereas work engagement was not significantly related to the job satisfaction dimension related to legal aspects for public organizations.

Conclusion

The vigor at work and work engagement were important variables to explain the authentic leadership-job satisfaction relationship in both private and public organizations. Nevertheless, the relationship between work engagement and the dimensions of job satisfaction was different for both organizations.

Authentic Leadership and Its Relationship With Job Satisfaction: The Mediator Role of Organizational Dehumanization

The objective of this research was to examine the mediating role that organizational dehumanization plays between authentic leadership and job satisfaction. The study was carried out with a sample of 422 participants, 50.7% were men and 49.3% women, with an average age of 38.96 years. The workers belong to different public and private organizations in Chile, and they responded to instruments of sociodemographic characterization, employment history and the scales of organizational dehumanization, authentic leadership, and job satisfaction. Data analysis included descriptive, correlational, and mediation analyses. The results allow us to maintain the hypothesis that organizational dehumanization plays a mediator role in the relationship between authentic leadership and job satisfaction. Implications of these findings are discussed.

The relationship between organizational commitment and work engagement among clinical nurses in China: A cross-sectional study

AIM

This study aims to investigate the levels of organizational commitment and work engagement among clinical nurses in tertiary hospitals and explore the relationship between them.

BACKGROUND

The nursing literature supports the idea that organizational commitment plays an important role in positively influencing job performance. However, the relationship between organizational commitment and work engagement among clinical nurses remains unclear.

METHODS

This was a cross-sectional study. A convenience sample of clinical nurses (n = 621) was selected from five tertiary hospitals in Sichuan Province of China. Survey instruments included a general information questionnaire about organizational commitment and work engagement. Univariate analysis, correlation analyses and linear regression analysis were used to examine the association between organizational commitment and work engagement.

RESULTS

The mean scores for organizational commitment and work engagement were 3.85 ± 0.59 and 4.58 ± 1.46, respectively. A moderate degree of positive correlation was found between them. Gender, monthly income and retention commitment were significantly associated with work engagement, and they accounted for 39.0% of the total variance.

CONCLUSIONS

Clinical nurses had a moderate level of organizational commitment and a high level of work engagement. Organizational commitment positively influenced work engagement; that is, organizational commitment is a significant determinant of nurses' work engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

Hospital organizations should focus on assessing and strengthening nurses' organizational commitment to promote increased work engagement and, ultimately, improved quality of care. This may include, but is not limited to, increasing rest time for nurses, implementing a performance appraisal system and focusing on nurses' psychological state.

Authentic leadership in nurses' professional practice: an integrative review

OBJECTIVES

to identify the primary constructs concerning authentic leadership and its relevance for nurses' professional practice.

METHODS

integrative literature review conducted between 2015 and 2020 in LILACS, SciELO, and PubMed databases.

RESULTS

the United States published most of the 31 studies analyzed, with eight studies (25.8%), followed by Canada with seven studies (22.6%), and Brasil with five (16.1%). Most studies adopted a quantitative approach (77.41%), and 96.8% presented weak evidence. Three categories emerged: Work Engagement/Job Satisfaction and Organizational Commitment; Healthy Work Environment; and Intention to Quit the Job and Mental Exhaustion.

FINAL CONSIDERATIONS

authentic leadership positively contributes to management and nursing care practice, promoting healthy work environments, structural empowerment, greater work engagement, and organizational commitment, decreasing absenteeism and mental exhaustion.

Primary care provider's job satisfaction and organizational commitment after COVID-19 restrictions ended: A mixed-method study using a mediation model

Objectives

More and more countries have decided to cancel most or even all COVD-19 restrictions. However, it is unclear how ending of restrictions will affect primary care providers' job satisfaction and organizational commitment. Our objectives are to explore the current status and possible change in primary care providers' job satisfaction and organizational commitment after massive restriction policies ended in China.

Methods

This was a mixed-method study that utilized structured questionnaires and semi-structured qualitative individual interviews. The 20-item Minnesota Satisfaction Questionnaire (MSQ) and 25-item organizational commitment survey were adopted to assess job satisfaction and organization commitment. Descriptive statistics and mediation models, as well as inductive thematic analysis, were used to analyze quantitative and qualitative data.

Results

A total of 18 interviews and 435 valid survey responses were included in our analysis. The average scores for job satisfaction and organizational commitment were 80.6 and 90.8. The thematic analysis revealed one major theme: ethical and moral responsibility to provide care as primary care providers, on which we established a mediation model. The mediation analysis revealed that normative commitment could positively affect the other four dimensions of organizational commitment and job satisfaction. The direct effect of affective commitment on job satisfaction was significant (LLCI = 0.11, ULCI = 0.31), and the mediators were identified to have a partial mediating effect instead of a total mediating effect.

Conclusion

After COVID-19 restrictions end, the job satisfaction and organizational commitment of primary care providers will return to levels before the pandemic and during this estimated process, a brief rise in resignation is predictable. The normative commitment positively affects the other four dimensions of organizational commitment and job satisfaction for primary care providers, which suggests a possible way to motivate primary care providers when restrictions end.

How perceived school culture relates to work engagement among primary and secondary school teachers? Roles of affective empathy and job tenure

Evidence suggests that perceived school culture is the most powerful predictor of teachers' work performance. However, studies to date have paid little attention to the potential mechanisms behind this association. On the basis of the job demands-resources (JD-R) model, the present study explored the mediating role of affective empathy and the moderating role of job tenure in the association between perceived school culture and teachers' work engagement. 647 primary and secondary school teachers completed questionnaires measuring perceived school culture, affective empathy, and work engagement. After gender and educational level were included as covariates, the results showed that perceived school culture positively correlated with teachers' work engagement, and more importantly, this association was partially mediated by affective empathy. In addition, job tenure significantly moderated the direct association between perceived school culture and work engagement. Specifically, there was a stronger association between perceived school culture and work engagement for teachers with shorter job tenure than those with longer job tenure. The findings suggested the direct effect of perceived school culture on work engagement, and the indirect effect of perceived school culture on work engagement through the mediating role of affective empathy. These findings enrich our understanding of how perceived school culture associates with work engagement, and highlight the moderating role of job tenure in the direct association between perceived school culture and work engagement.

What Quality of Care Means? Exploring Clinical Nurses’ Perceptions on the Concept of Quality Care: A Qualitative Study

Quality is a multidimensional issue involving various features that depend on service performance and personal assessment. Clarifying the concept of quality is essential in order to further facilitate the understanding and improvement of quality in healthcare. The purpose of this study was to investigate how clinical nurses, providing care to adult medical patients, perceive and define the concept of quality nursing care. A descriptive qualitative research design was applied. A purposive sampling strategy was used to recruit nurses from the clinical sector of a general public hospital in Athens, Greece. Ten female nurses from the medical sector participated the study. Data collection was conducted through in-depth, semi-structured interviews. Conventional content analysis was used to analyze the verbatim data. Four categories were revealed from the data analysis, namely: (a) “Quality care is holistic care”, (b) “Good care is an interpersonal issue”, (c) “Leadership is crucial”, and (d) “Best care is our responsibility”. Quality care was defined as holistic care, addressing all patient needs with competency and aiming for the best patient outcomes. It was associated with communication, teamwork, good leadership, and personal commitment. By developing an in-depth and mutual understanding about what quality means, nurse leaders and practitioners may collaborate in finding common paths to support quality interventions and enhance quality nursing care in clinical practice.

Performance Effects of High Performance Work Systems on Committed, Long-Term Employees: A Multilevel Study

Even though effects of High Performance Work Systems (HPWS) on employee performance have been widely investigated, there is no consensus on how this link is achieved. Drawing on Social Exchange Theory (SET), this paper attempts to shed more light in this relationship by investigating the mediating role of affective, normative, and continuance commitment in the relationship between HPWS and employee performance. Moreover, the potential moderating role of employee tenure on the HPWS-organizational commitment link is examined. Using data from 342 subordinates and 115 supervisors from 111 service organizations in Greece, our multilevel analysis shows that affective commitment fully mediates the relationship between HPWS and employee performance. In addition, employee tenure positively moderates the relationships between HPWS and affective and normative commitment. The paper discusses theoretical implications and provides recommendations for practitioners.

The impact of organisational commitment and leadership style on job satisfaction of nurse practitioners in acute care practices

AIM

To determine the main factors that affect nurse practitioners' job satisfaction, especially the relationship between organisational commitment and leadership styles in acute care practices.

BACKGROUND

There is little known about the influence of organisational commitment and leadership on NPs' job satisfaction within acute care hospitals.

METHODS

A cross-sectional design with a national online survey that enrolled 1,205 nurse practitioners from the Taiwan Association of Nurse Practitioners to identify potential variables associated with job satisfaction using the multiple regression model.

RESULTS

Organisational commitment (mean=59.47), job satisfaction (mean=173.47), and leadership style (mean ranged from 13.29 to 28) were at a moderate level. Organisational commitment, leadership style, patient load and nurse practitioner advancement levels explained 63% of the variance in nurse practitioners' job satisfaction.

CONCLUSIONS

Organisational commitment and leadership styles, such as idealised influence and individual consideration, are major factors that impact nurse practitioners' job satisfaction.

IMPLICATIONS FOR NURSING MANAGEMENT

Healthcare organisations should develop policies targeting organisational commitment and managers' leadership styles to improve nurse practitioners' job satisfaction.

A liderança autêntica no exercício profissional do enfermeiro: uma revisão integrativa

RESUMO Objetivos: identificar os principais construtos adotados sobre a liderança autêntica e sua relevância para a prática profissional do enfermeiro. Métodos: revisão integrativa da literatura no período de 2015 a 2020, nas bases de dados: LILACS, SciELO e PubMed. Resultados: dos 31 estudos analisados, os países que mais publicaram foram Estados Unidos, com 8 estudos (25,8%), Canadá com 7 (22,6 %) e Brasil com 5 (16,1%); houve predomínio de estudos de abordagem quantitativa (77,41%), e 96,8% apresentaram nível de evidência fraca. Emergiram três categorias para discussão: Engajamento/Satisfação no trabalho e comprometimento organizacional; Ambiente de trabalho saudável; Intenção de sair do emprego e desgaste mental. Considerações Finais: a liderança autêntica contribui positivamente na gestão e na prática do cuidado do enfermeiro, proporcionando ambientes de trabalho mais saudáveis, empoderamento estrutural, maior engajamento no trabalho e comprometimento organizacional, além de contribuir para diminuição das taxas de absenteísmo e desgaste mental.

Gender disparity in leadership boosts affective commitment and tacit knowledge sharing about libraries

Purpose

This study aims to use an authentic leadership style to explore that whether male or female leadership of private academic institutions highly influences affective organizational commitment and tacit knowledge sharing among the library teachers. Additionally, this study encompasses the trust of library teachers and justifies whether the trust under male or female leadership highly moderates the effect on tacit knowledge sharing.

Design/methodology/approach

By using structural equation modeling, this study tests two leadership models (e.g. male and female leadership models). Using a convenient sampling approach, the researcher collects data from library teachers of private academic institutions in district Sheikhupura, Pakistan through face-to-face interaction. The study administered 650 survey questionnaires among the library teachers; however, 403 questionnaires were answered validly and reliably. The response rate was 62%.

Findings

The study found the direct and indirect effect of authentic leadership on affective organizational commitment and tacit knowledge sharing however, male authentic leadership influence on affective organizational commitment and tacit knowledge sharing was quite higher than female authentic leadership. Resultantly, the library teachers were more committed to sharing tacit knowledge under male leadership than female. Nevertheless, the moderating role of trust was found in female leadership but not in male leadership. Simply, the library teachers under male leadership were hesitant to trust others, so the chain of sharing hidden ideas and image of libraries was not found in male leadership.

Practical implications

Private academic institutions need authentic leaders to shape the knowledge economy of libraries and the structure of the academic institutions. For this reason, this study provides practical implications for managers that male leadership should be hired in academic institutions because it has a higher influence on librarians’ commitment and tacit knowledge sharing among peers as compare to female leadership.

Originality/value

To the best of the authors’ knowledge, this was the first study that differentiates the capabilities and skills of male and female authentic leadership in private academic institutions. Further, it suggests hiring male leaders in these institutions.

Authentic leadership, nurse satisfaction at work and hospital accreditation: study in a private hospital network

OBJECTIVES

to identify the dominant dimensions of the authentic leadership of nurses in a private hospital network and to verify the association with job satisfaction and accreditation.

METHODS

cross-sectional, analytical study carried out in 11 hospitals with 282 nurses, of which 94 were leaders and 188 were led. Participants answered the Authentic Leardership Questionnaire and the Job Satisfaction Survey.

RESULTS

there was a significant difference between the assessment of leaders and followers in all dimensions of the Authentic Leardership Questionnaire. Regarding the association of authentic leadership and job satisfaction, a significant positive moderate correlation was found among the employees. In hospitals accredited by the Joint Commission International, leaders were perceived as more transparent by their subordinates.

CONCLUSIONS

there was correlation between authentic leadership and job satisfaction and authentic leadership and the accreditation model among the subordinates.

Effects on staff outcomes and process evaluation of the educating nursing staff effectively (TENSE) program for managing challenging behavior in nursing home residents with dementia: A cluster-randomized controlled trial

BACKGROUND

Challenging behavior is prevalent in people with dementia residing in nursing homes and places a high burden on the nursing staff of dementia special care units. This study evaluates an educational program for nursing staff for managing challenging behavior: The Educating Nursing Staff Effectively (TENSE) program. This program can be tailored to care organizations' wishes and needs and combines various learning styles.

OBJECTIVE

The aim of this cluster-randomized controlled trial was to examine the short-term (3 months) and long-term (9 months) effects of the TENSE training program on experienced stress, work contentment, and stress reactions at work in nursing staff working in dementia special care units.

DESIGN

Cluster-randomized controlled trial.

METHODS

Nursing staff members of 18 dementia special care units within nine nursing homes from different Netherlands regions were randomized into an intervention (n = 168) or control (n = 129) group. The TENSE program consisted of a three-day training course and two follow-up sessions after three and six months, respectively. The primary outcome was stress experienced by nursing staff measured with the Utrecht Burnout Scale - C. Secondary outcomes were work contentment and stress reactions at work. Furthermore, process evaluation data on the reach of and compliance with the program and the program's feasibility and relevance were collected. Data were collected between November 2012 and November 2014.

RESULTS

In general, the participants appreciated the quality and relevance of the TENSE training and evaluated the content of the training as beneficial. The TENSE training had no effect on the components of experienced stress, i.e., emotional exhaustion (p = 0.751), depersonalization (p = 0.701), and personal accomplishment (p = 0.182). Furthermore, no statistically significant effects of the intervention on work contentment and stress reactions at work were found.

CONCLUSIONS

The TENSE training program did not have an effect on experienced stress, work contentment, nor stress reactions at work of nursing staff working in dementia special care units. In future studies, more focus on practicing new skills seems needed.

TRIAL REGISTRATION

NTR (Dutch Trial Registration) number NTR3620.

Fostering Workplace Innovation through CSR and Authentic Leadership: Evidence from SME Sector

The cut-throat situation of competitiveness in almost every business sector, followed by globalization, shortened product life cycles, and rapid technological changes have raised the importance of innovation to overrun the rivals. Scholars have established that appropriate leadership style is a key enabler for organizational success. However, it is not clear in existing literature how the concept of authentic leadership is related to innovative work behavior (IWB). Likewise, the role of corporate social responsibility (CSR) to induce IWB is also vague in current literature. Thus, the basic purpose of the current study was to test the relationship of CSR and IWB with the mediating effect of authentic leadership. The proposed model was tested in the small and medium-sized enterprises (SMEs) sector of China. The data were collected through a questionnaire that was distributed among different respondents of the current survey. The data were obtained from a dyad of supervisor and subordinate serving in different SMEs in Wuhan city of China. The study used the structural equation modeling (SEM) technique to validate different hypotheses. The empirical results confirm that CSR positively relates to IWB while authentic leadership partially mediates this relationship. The findings of the current survey will be helpful for policymakers to recognize employees as a source of innovation through CSR and authentic leadership.

Perceptions of Authentic Nurse Leadership and Work Environment and the Pandemic Impact for Nurse Leaders and Clinical Nurses

OBJECTIVE

The aim of this study was to determine the pandemic impact on the relationship between nurses' perception of the authentic nurse leadership (ANL) of their manager and their perception of the work environment.

BACKGROUND

Both ANL and healthy work environment (HWE) contribute to staff and patient outcomes. Our 1st study of these 2 variables revealed a positive relationship. Will this be upheld in a pandemic year?

METHODS

More than 5000 nurses from a national sample participated in a cross-sectional, correlational, descriptive study using the Authentic Nurse Leadership Questionnaire, the Critical Elements of a Healthy Work Environment Scale, and a pandemic impact on practice question.

RESULTS

Overall, nurses perceived ANL and HWE were present despite a high level of pandemic impact; however, when clinical nurses were separated from managers/directors, HWE was not present for frontline nurses. The moderate correlation of ANL and HWE was replicated in this larger study.

CONCLUSIONS

This is the 2nd study of the positive relationship between ANL and HWE using these models, supporting ANL as an essential standard of a HWE. ANL was present for clinical nurses in a pandemic year signaling that nurse leaders rose to meet frontline leadership needs. HWE was present overall, but not for clinical nurses. Leadership is essential to work environments and outcomes especially in times of crisis and significant change.

Model of Organizational Commitment Applied to Health Management Systems

In this paper, we try to build on the problems surrounding the management of human resources in health care organizations worldwide. After the analysis of the reviewed literature, we detected that the scientific community considers several recurring themes that need attention: stress, burnout, and turnover intention. Based on this, we developed a model of organizational commitment that aims to achieve performance and health quality, its main result the establishment of the appropriate management policies in order to avoid the abandonment of the organization through the search for commitment and job satisfaction. Amongst our main conclusions, we highlight the need to implement a human resources model for hospital administrators based on the relationships with "patients" not "clients" through the maintenance of a positive and strong atmosphere of staff participation. It is important to develop innovative practices related to clear job design that eliminate reasons for ambiguity and stress in executing the tasks of the healthcare system. Finally, we urge training programs in transformational leadership to promote the well-being and organizational commitment of employees.

Unit work environment, psychological empowerment and support for patient activation among nurses

AIMS

To investigate the relationship between the unit work environment and psychological empowerment of nurses and their perceptions of patient activation.

BACKGROUND

Nurses' support for active patient roles in the care process is critical for better patient outcomes. The factors influencing nurses' support for patient activation should be thoroughly investigated.

METHODS

This study was a cross-sectional secondary data analysis using the survey data of 1,042 nurses in 98 units at six hospitals in Korea.

RESULTS

Nurses with perceptions that their work was valuable and autonomy in their work were more likely to work in units where managers had greater managerial and leadership skills and staffing and resources were sufficient. Those with confidence in their work were more likely to work in units with adequate staffing and resources. Nurses who worked with adequate staffing and resources and considered their work meaningful were more likely to perceive patient activation as more important.

CONCLUSION

Favourable work environments at unit level and psychological empowerment at nurse level can strengthen nurses' support for patient activation.

IMPLICATIONS FOR NURSING MANAGEMENT

To strengthen nurses' support for active patient roles, organisations should ensure optimal staffing and resources to each unit and help nurses find value in their work.

Explaining the effect of authentic and ethical leadership on psychological empowerment of nurses

OBJECTIVE

This study aimed to explain the effect of authentic and ethical leadership on the psychological empowerment of nurses.

BACKGROUND

Ethics-related leadership styles can play an important role in improving employee performance by influencing job satisfaction. However, no study has investigated ethics-related leadership and its impact on the psychological empowerment of nurses.

METHOD

The present study is a descriptive correlational study with emphasis on structural equations. A random sample of 384 nurses in public hospitals in Tehran responded to three self-report questionnaires.

RESULTS

The authentic leadership variable explains 74.5% of the variance of the psychological empowerment variable. In addition, the variable of ethical leadership explains 87.7% of the variance of psychological empowerment variable.

CONCLUSION

Ethical and authentic leadership is effective on the nurses' psychological empowerment.

IMPLICATIONS FOR NURSING MANAGEMENT

Ethical and authentic leadership is necessary for managers to psychologically empower nursing staff. Increasing awareness of capabilities of nurses and how decisions and behaviours affect them, balanced information processing, observance of ethics in the workplace, transparency in communication, information and power sharing, all impact justice in the workplace.

Nursing and values-based leadership: A literature review

AIM

To explore literature that supports an understanding of values-based leadership in nursing.

BACKGROUND

Understanding values-based leadership in nursing means understanding several leadership theories such as authentic, servant and congruent leadership.

EVALUATION

Electronic databases were systematically searched to locate studies with the terms values-based, authentic, servant and congruent leadership. The literature was assessed with the Joanna Briggs Institute Critical Appraisal Tools and the Preferred Reporting Items for Systematic Reviews and meta-analysis approach and a thematic analysis.

KEY ISSUES

Existing evidence focuses on specific perspectives within three dominant leadership approaches under the umbrella of values-based leadership: authentic, servant and congruent leadership. Limited literature suggests that values-based leadership can support professional collaboration, enhanced trust and voice for nurses, support for staff well-being, empowerment, job satisfaction, patient-focused outcomes and quality care.

CONCLUSIONS

A dearth of empirical literature concerning values-based leadership and nursing exists. Evidence suggests that authentic, servant and congruent leadership correlate with values-based leadership theories and core nursing values.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers should recognize the potential benefits of a values-based leadership approach for staff well-being, enhanced professional collaboration and the nurses voice, improved insight into clinical leadership attributes and improvements in quality patient care.

Moderating Effects of Structural Empowerment and Resilience in the Relationship between Nurses' Workplace Bullying and Work Outcomes: A Cross-Sectional Correlational Study

This cross-sectional correlational study aimed to evaluate the moderating effects of structural empowerment and resilience in the relationship between workplace bullying and nursing work outcomes. Data were collected from 435 nurses and nurse managers working at a tertiary hospital in Seoul, South Korea. The moderating effects were examined using stepwise hierarchical multiple regression models. The bootstrapping method was utilized to verify the magnitude and significance of the moderating effects. Structural empowerment showed a moderating effect in the relationship between workplace bullying and nursing work outcomes: for the conditional values above the average level of structural empowerment, workplace bullying was significantly associated with nursing work outcomes, while work outcomes were low regardless of workplace bullying for the conditional values less than average. However, resilience had no moderating effect. To improve work outcomes, bullying must be reduced and structural empowerment and resilience increased.

Work Schedule Characteristics, Missed Nursing Care, and Organizational Commitment Among Hospital Nurses in Korea

PURPOSE

This study describes Korean nurses' work schedule characteristics and identifies their components to investigate associations of work schedule components with missed nursing care and organizational commitment.

DESIGN

This cross-sectional secondary analysis used survey data of 1,057 nurses in 111 units at six hospitals in South Korea. Data were collected between April 2017 and March 2018.

METHODS

A self-administered survey, including seven work schedule characteristic items, the Korean version of the MISSCARE Survey, and the Korean version of the Organizational Commitment Questionnaire, was employed. To construct independent components of work schedule characteristics, a principal component analysis was performed. The associations of work schedule components with missed nursing care and organizational commitment were analyzed using multiple linear regression models with generalized estimating equation methods.

FINDINGS

The average number of daily work hours was 9.7. Nearly half of the study population worked while sick once or more per month. The two components of nurses' work schedule characteristics were "long work hours" and "lack of rest," and these components showed variations between units. Unhealthy work schedule components were linked to frequently missed nursing care and decreased organizational commitment.

CONCLUSIONS

This study showed that proper work hours and adequate rest are important to reduce missed nursing care tasks and enhance organizational commitment, both of which are critical for better patient care and organizational outcomes.

CLINICAL RELEVANCE

Healthcare organizations should provide adequate nursing staff and assign reasonable workloads. Furthermore, hospitals should periodically monitor the work schedule characteristics of nurses and actively intervene in cases of scheduling issues to resolve them.

Positive Supervisor Behaviors and Employee Performance: The Serial Mediation of Workplace Spirituality and Work Engagement

Organizational research has highlighted the crucial role of supervisors in promoting employee well-being and performance. According to the motivational approach, supervisors positively influence employees' outcomes by enhancing their positive feelings. In this study, we examine how positive supervisor behaviors may improve employee performance through the serial mediation of workplace spirituality and work engagement. Data were collected from 330 Italian employees. Results showed that supervisor integrity and responsible behaviors have a positive effect on employee performance directly; moreover, positive supervisor behaviors influence performance indirectly, through both the partial mediation of work engagement and the serial mediation of workplace spirituality and work engagement. The present study highlighted that supervisors should behave responsively and honestly to trigger a virtuous motivational process in their employees, which leads to boost their performance. The practical implications of these findings are discussed.

The impact of person-centred care on job productivity, job satisfaction and organisational commitment among employees in long-term care facilities

AIM AND OBJECTIVES

This study aimed to explore the effects of person-centred care on their job productivity, job satisfaction and organisational commitment among employees in long-term care facilities.

BACKGROUND

Person-centred care has been regarded as the best caregiving model for long-term care facilities. Few studies tested the impact of person-centred care on employee performance.

DESIGN

A cross-sectional study was employed.

METHODS

This study sent 373 samples with self-report questionnaires to the employees of sixteen long-term care facilities in Taiwan. A total of 366 valid samples were collected. A 33-item person-centred care questionnaire with Likert-scale responses was developed to assess the extent of person-centred care. We adopted hierarchical multiple regression analysis to test the impact of person-centred care on employee performance. We adopted the STROBE guidelines.

RESULTS

Friendly environment level and personalised care, respectively, scored the highest with a mean of 4.19 among five dimensions of person-centred care. Personalised care, residents' self-realisation and relationships, and organisational support had significant positive correlations with job productivity. Friendly environment level and organisational support had significant correlations with job satisfaction. Friendly environment level, residents' self-realisation and relationships, and organisational support had significant correlations with organisational commitment.

CONCLUSION

Person-centred care has beneficial impact on job satisfaction, job productivity and organisational commitment of employees in long-term care facilities.

RELEVANCE TO CLINICAL PRACTICE

Person-centred care appears to be a crucial factor of employee performance in long-term care facilities. The five-dimensional person-centred care questionnaire in this study can serve as an important management tool for improving the effectiveness of person-centred care.